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Management of multiple sclerosis and neuromyelitis optica in pregnancy and childbearing
Author(s) -
Shimizu Yuko
Publication year - 2015
Publication title -
clinical and experimental neuroimmunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.297
H-Index - 15
ISSN - 1759-1961
DOI - 10.1111/cen3.12185
Subject(s) - pregnancy , childbirth , medicine , neuromyelitis optica , multiple sclerosis , disease , obstetrics , fetus , pediatrics , immunology , genetics , biology
The age of onset of multiple sclerosis ( MS ) is between the 20s and 40s, and as this is the fertile age range for women, childbirth and pregnancy among MS patients are issues encountered by medical professionals on a daily basis. To ease the anxieties felt by patients, it is important for medical professionals to have the correct knowledge about pregnancy and childbirth, so they can guide and support women in the process leading up to a safe delivery. Although the activity of MS remains stable during pregnancy, because immunological tolerance of the fetus within the mother's body comes into effect, there is characteristically a high risk of relapse during the puerperal period. Stabilizing the disease activity before pregnancy helps to reduce the risk of relapse after childbirth; it is essential to start patients with high disease activity on treatment with a disease‐modifying therapy, such as interferon‐β before pregnancy to maintain remission. A disease‐modifying therapy that has little effect on the fetus is desirable for this purpose. For childbirth and pregnancy among patients with neuromyelitis optica, although the relapse rate does decrease during pregnancy, this decrease is not as pronounced as that seen in the third trimester in MS , and the relapse rate 3–6 months after childbirth tends to be higher than that for MS . Greater care is required to prevent relapse during pregnancy and after childbirth in neuromyelitis optica than in MS .